[unreadable] [unreadable] In this project, members from the American College of Surgery (ACS) and the Anesthesia Patient Safety Foundation (APSF) are collaborating to expand the ACS National Surgery Quality Improvement Program (NSQIP) data repository to include anesthesia-related intra-operative data. The ACS NSQIP program is already capturing information on preoperative patient risk factors, surgical factors, and adverse events following surgery. However, the effects of anesthetic management on postoperative outcomes remain unclear because the ACS NSQIP database contains no information on anesthetic management or physiologic variables during surgery. This project will assess the technical feasibility of structuring intraoperative anesthesia and physiologic data and mapping these data into the ACS NSQIP database. [unreadable] [unreadable] The goal to extend the ACS NSQIP system infrastructure to incorporate direct data capture of intraoperative variables from AIMS systems speaks to the heart of the IAIMS Next Generation Agenda; namely creating tools and resources to build national research repositories to support discovery, innovation and dissemination of research results that leads to improvement in health outcomes. The main reason that anesthesia information is missing from the ACS NSQIP database is that the lack of standards in both terminology and record structure prevents the transfer of intra-operative anesthesia data from AIMS into outcomes databases. The creation of a standard terminology and record structure is an essential requirement to support the movement of intra-operative data from AIMS into outcomes databases. [unreadable] [unreadable] The proposed project has 3 phases: 1) To design a structured model of the anesthesia record using a [unreadable] controlled vocabulary which will be developed after examining the anesthesia-related data at nine [unreadable] performance sites; 2) To implement a prototype based on structured model that will test the feasibility of importing data from AIMS to enhance the ACS NSQIP data repository; 3) To prepare an AIMS [unreadable] implementation plan for the introduction of the expanded ACS NSQIP platform in the follow-up phase. This proposal will address the conceptual challenge of creating a model, the technical challenge of constructing a prototype based on the model, and the organizational challenge of building consensus among the members of the ACS NSQIP. [unreadable] [unreadable] [unreadable]